What is the role of nuclear medicine techniques in the diagnosis of musculoskeletal infection?
Technetium-99m ( 99m Tc) methylene diphosphonate (MDP) bone scintigraphy (“bone scan”), Indium-111 ( 111 In) white blood cell (WBC) scintigraphy (“WBC scan”), and fluorine-18 ( 18 F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) are available nuclear medicine techniques that can be used to diagnose musculoskeletal infection. Currently, their use has been largely eclipsed by MRI, although they remain useful for problem-solving applications.
For example, the diagnosis of periprosthetic infection (osteomyelitis adjacent to orthopedic hardware) is difficult by MRI because of field distortion effects around metal. Similarly, the diagnosis of infection at the site of a recent fracture (when bone marrow edema and soft tissue edema are expected) can be challenging with anatomic imaging techniques. In these and other challenging cases, nuclear medicine techniques can provide valuable diagnostic information.
